Georgetown Univ. Medical Study On Hookahs

[Scheetz]

http://explore.georgetown.edu/news/?ID=18216

for those that dont want to read the link here it is.

Hold the Hookah: Researcher Warns Against Trendy Tobacco Use
Study shows global trend of smoking tobacco through a waterpipe, also known as a hookah; more young people and women have taken up the habit


Washington, D.C. -- The growing fad of smoking tobacco through a waterpipe, sometimes known as a hookah, is rapidly turning into a worrisome epidemic, according to a Georgetown University researcher who says smokers who think this form of tobacco use is less toxic than cigarettes are wrong.



“People who use these devices don’t realize that they could be inhaling what is believed to be the equivalent of a pack of cigarettes in one typical 30-60 minute session with a waterpipe, because such a large quantity of pure, shredded tobacco is used,” said Christopher Loffredo, Ph.D., Director of the Cancer Genetics and Epidemiology program at Georgetown University Medical Center.



His series of recently published studies documents the trend toward waterpipe tobacco smoking, showing how it has swept through the Middle East and is gaining popularity in the West, and demonstrates that the amount of cellular chromosomal damage produced inside the mouth is the same as that seen in cigarette smoking.



Yet waterpipe cafes or bars have been popping up all over the Eastern Mediterranean region over the past decade, Loffredo said. “In Egypt, we’ve seen boys starting to smoke the waterpipe at age 12, and young women, who are culturally discouraged from smoking cigarettes, are flocking to it,” said Loffredo, who has been studying tobacco use in that country since 1997.



The trend has now hit European and American cities, especially college towns. “This is frightening because it is a gateway toward a lifetime use of tobacco, including cigarettes,” he said.



Waterpipes were originally developed to smoke hashish and other substances, but were long ago adapted into a method to smoke tobacco. Use of the device is common throughout the Middle East, where it is goes by a number of different names--shisha in Egypt, hookah in Pakistan and India, and narghile in a number of countries from Turkey to Israel--but has historically been “a habit of older men, usually of low socioeconomic level, in rural areas and in older parts of cities,” he said.



But the waterpipe has gained wider appeal since the early 1990s, accompanied by alterations in waterpipe size and design and also in tobacco content and flavorings, Loffredo said. “These changes are designed to attract more customers to the habit, and there has even been the introduction of tobacco home delivery service in some areas.”



Several popular clubs in the Washington, D.C., area, offer hookah pipes at a fee, using tobacco flavored by apples, molasses, or other ingredients. The pipe is often a social activity in that it is usually passed between participants, and is believed to be less toxic, Loffredo said.



“People think the water absorbs the toxins, and that is true to some extent if the toxins are water soluble, but tar isn’t, and tar contains the carcinogens,” he said. “We believe that, compared to the typical cigarette smoker, waterpipe smokers are exposed to larger total amounts of nicotine, carbon monoxide and certain other toxins.”



“And because the tobacco is burning at a lower temperature, it is more tolerable to inhale deeply, and in fact you need more force to pull air through the high resistance of the water pathway,” Loffredo said. “That means the tobacco smoke can be penetrating deeper in a person’s respiratory tract than cigarette smoke does. The damage could be even worse than seen in cigarette smokers, but we haven’t done studies long enough to quantify the true cancer risk.”



Even so, the incidence of lung cancer is increasing rapidly in Egypt and other Middle Eastern countries, comparable to lung cancer rates in the U.S. after cigarette smoking became newly fashionable, Loffredo said.



His insights into “this significant and spreading epidemic of waterpipe smoking” were included in a recently released World Health Organization monograph authored by his research group. He also published a study in the July/August issue of the pathology journal Acta Cytologica about a new method his group developed to collect cheek cells from inside a participant’s mouth, which can then be stained to gauge the chromosomal condition of these cells. They used this technique to study waterpipe smoking in a rural Egyptian village, and reported in a second study, published in 2003 in the Journal of the Egyptian Society of Parasitology, that the level of damage is comparable to what happens to cigarette smokers.



The trend is also having a disproportionate impact on college-aged women. Another study, reported in a forthcoming issue of the journal Nicotine and Tobacco Research, documents how women attending university in Cairo have gravitated to waterpipe tobacco smoking, which is traditionally “culturally abnormal for women to smoke cigarettes, at least in front of their husbands and families.” The presence of waterpipe cafes frees women from social stigma, allowing them to view use of waterpipe tobacco in the context of social and economic liberation, Loffredo said. Yet the researchers found that these students, even those in medical school, had only an average knowledge of tobacco-related health hazards.



Loffredo, whose studies are funded by the National Institutes of Health, says the entire field of waterpipe health effects “is ripe for new and comprehensive research,” including toxicological and pathological investigation to precisely determine heath risks, he said. “The world really didn’t foresee the epidemic of waterpipe tobacco smoking, and now it is time to pay attention,” Loffredo said.

sure its unhealthy, but we all know that. These studies are stupid though. Its just like cig studies the scientists are paid to sway a certain way. I listen to this shit when someone does a study on a 60 yearold person that has only smoked a hookah and nothing else for 30 years. Then I am curious as to what has happend.

I will also keep smoking because my father used to smoke 3 packs a day, yes 3 packs and these were unfilitered. He was smoking before Joe Camel ever came out when he was 13. Hes perfectly fine, the only thing he has was hes on the edge of Diabetes. But he is also slightly overweight which is more of the cause as told by the doctor. What moved him back to perfect health, was he dropped 20lbs and everything went back to normal.

[RayVer]

“People think the water absorbs the toxins, and that is true to some extent if the toxins are water soluble, but tar isn’t, and tar contains the carcinogens,”

I thought Shisha didn't have any tar. All my packages read 0.00%

[Whodat1004]

Everytime I see studies like this I think of the movie "Thank you for smoking."

[ASUSEAN1]

i just emailed them about the whole tar thing. also argured about there whole testing and how you don't hit a hookah constantly like the achines test. i will let you know what they say

[mgcsinc]

I've read that Georgetown thing, and most of it's just scare-tactic fluff. I haven't read any of the actual studies, though - they might be more substantive.

On the other hand, I am amused by your willingness to shrug off a half-century of fantastic research on the dangers of cigarette smoking because of one outlier (your father). Amused because that's what cigarette companies want you to do. As part of the cigarette companies' settlement with the state AG's in the 90's, they were forced to release a mountain of incriminating internal documents; they are online, in searchable form, I believe. If you go and look through them, you will find page after page of big tobacco execs making fun of the fact that they are able to dupe consumers (just like yourself, although I don't know if you actually smoke cigs) with their campaigns at creating doubt in the minds of consumers. Outliers, like your father or the one scientist in Alaska bumblefuck who still doesn't believe the health connection, were a huge part of this campaign.

Before cigarettes were produced at a massive scale, lung cancer was very rare. Doctors would flock to see the occasional cases that did pop up, because it might be their only opportunity to see this rare disease. Now, lung cancer is the leading cause of cancer death for men and women in the westernized world. 94% of lung cancer patients are smokers. If that's not compelling, look at http://en.wikipedia.org/wiki/Image:Cancer_...on_from_NIH.png . The impact of smoking on a variety of other aspects of health is well documented. If you honestly believe that smoking will not take years off you life (not to mention making those last years a living hell), you are very much in the minority.

Beyond that, the assertion that the cigarette research has been swayed towards finding cigarettes to be unhealthy by money is borderline insanity, and yet people continue to make it. I don't have time to go into it, but suffice it to say that the cigarette companies have participated for a century in the most evil of anti-scientific procedures to ensure that the role of smoking in health problems and addiction was minimized. This includes making conditional grants, physical intimidation, and shutting down internal labs that produced results that were contrary to their interests. Compared to these multi-billion dollar industries, public health agencies have little in the way of ability to sway researchers. They are good people interested in saving lives cut short by a substance that (in the case of processed cigarettes) is anything but natural.

Hookah is different. I smoke it because I like it, and it is not addictive in the way that cigarettes are. I can (and have, at times) go very long without smoking hookah. But I know about the health issues, and I do not try to minimize them by pointing to individuals at the very end of a normal curve or making absurd claims about research impropriety.

[angemonkwj]

i would like to know why the doctors and the government think that it's there job to tell me how to live my life.....ie what to eat, drink, smoke. i know what is good and not good for me. i do it cause i enjoy it.

[ghostofdavid]

OH NOOOOOOOOOOOOES!!! I have been trix0red into smoking hookah by big tobacco!!! Help me!Q! I cannot escape their good flavours... plzhelpmegovt.!@!!!!!!!!!!!!1111

[glz88]

Well i have to issues with the "study" one it does not have any numbers, second no argument. It is bad and increasing are statements are very broad and general. Also the traditional hookahs were used to smoke tobacco originally nothing else.

I want to see some M.D. and Data. Also I want a medical journal to check the reliability of the data. Other than that its crap.

[mgcsinc]

For the record, what Scheetz posted was not a study. It was a news release. There is no need to bash it for being a bad study given that it isn't one.

Edit: And for people who want numbers and an experimental design, I will post a real study later on tonight, if I get a chance, as well as responding in an old thread about hookah research that I've been neglecting for a few weeks. Edited February 6, 2007 by mgcsinc

[mgcsinc]

i would like to know why the doctors and the government think that it's there job to tell me how to live my life.....ie what to eat, drink, smoke. i know what is good and not good for me. i do it cause i enjoy it.

That would be true if the nicotine in tobacco was not addictive. As it is, many people would disagree with you for that reason.

Edit: Additionally, please note that those doctors are the ones who will be repairing your diseased heart and lungs, and that government will be the one footing your Medicare bill. Edited February 6, 2007 by mgcsinc

[Pieces]

Also the traditional hookahs were used to smoke tobacco originally nothing else.

Try Opium.

And I have to agree that this "study" is total bull. As someone mentioned, we don't hit a hookah some hundreds of times a minute like the testing machines, and there's no tar in the shisha. Asu, please do let us know what their reply is.

[mgcsinc]

Also the traditional hookahs were used to smoke tobacco originally nothing else.

Try Opium.

And I have to agree that this "study" is total bull. As someone mentioned, we don't hit a hookah some hundreds of times a minute like the testing machines, and there's no tar in the shisha. Asu, please do let us know what their reply is.

Your response doesn't make any sense. You call this a "study" (it isn't), then you attack it's methods, despite the fact that you don't know what they were.

Everybody's in a furor over the legitimacy of a study that they know nothing about. What that says to me is that you will be unwilling to accept these results even if they turn out to be from a study conducted in a very legitimate manner. I can think of nothing more unscientific than that kind of reaction.

[angemonkwj]

im not upset about this report. if something were to come out that was legitimate i would accept the results. at the same time, the results arent going to make me stop doing something i like to do because someone says it's bad for me. your argument about being addictive is a moot point. people break addictive habbits all the time...ie smoking, drugs, alcohol. in the end, for me at least, it boils down to do i enjoy it? if the answer is yes then i dont care what the studies and the doctors and the politicians say. it's my choice to do what i want.

[angemonkwj]

OH NOOOOOOOOOOOOES!!! I have been trix0red into smoking hookah by big tobacco!!! Help me!Q! I cannot escape their good flavours... plzhelpmegovt.!@!!!!!!!!!!!!1111

LMFAO!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[web250]

I want to see a study with good research. Something that says explicitly:
We had four machines sharing a one hose hookah, taking 3-4 normal drags before passing it to the next machine. I also want to know brands, coals, setup, etc.

For some reason I doubt how authentic these "studies" are.

[Allia22]

I want to see a study with good research. Something that says explicitly:
We had four machines sharing a one hose hookah, taking 3-4 normal drags before passing it to the next machine.

I would LOVE to see that!

[OPR234]

“People who use these devices don’t realize that they could be inhaling what is believed to be the equivalent of a pack of cigarettes in one typical 30-60 minute session with a waterpipe, because such a large quantity of pure, shredded tobacco is used,” said Christopher Loffredo, Ph.D., Director of the Cancer Genetics and Epidemiology program at Georgetown University Medical Center.

Does shisha even qualify as "pure" shredded tobacco with all of its glycerin, honey, molasses, dyes, and flavorings? They're most likely testing with Tombak or however you spell it, although none of us can be sure. There is an enormous of lack of details in the article for any conclusions to be drawn. I don't even know what they're 'smoking' and testing on.

As many people before me have said, smoking in any way is obviously bad for you. Are cigarettes worse for you than shisha? In my opinion, I say they are, but not by much. I say that because most cigarettes have weird additives like ammonia and stuff that can't be good for you, but shisha delivers more nicotine (unwashed) and carbon monoxide. I don't know for sure, thats just the way I like to see it.

[djbomberto]

IMO they don't waste time on these studies for no reason. I do believe that Hookah does give more smoke than cig's, hence more deadlier, but then again thats my opinion. Also its not the GOV telling you how to live your life. Since when does George associated with the Gov?.....hum..........If they didn't publish findings or anything like that, everyone would be on steroids saying "ULTIMATE WEIGHT GAINER" and would bitch and moan, when your balls fall off and your bones fuse together. So Im done. Live your life the way you wanna

[mgcsinc]

I want to see a study with good research. Something that says explicitly:
We had four machines sharing a one hose hookah, taking 3-4 normal drags before passing it to the next machine. I also want to know brands, coals, setup, etc.

For some reason I doubt how authentic these "studies" are.

For the tenth time, what was posted was not a "study" nor does it claim to be. All actual studies will tell you exactly what you are looking for. Edited February 6, 2007 by mgcsinc

[mgcsinc]

“People who use these devices don’t realize that they could be inhaling what is believed to be the equivalent of a pack of cigarettes in one typical 30-60 minute session with a waterpipe, because such a large quantity of pure, shredded tobacco is used,” said Christopher Loffredo, Ph.D., Director of the Cancer Genetics and Epidemiology program at Georgetown University Medical Center.

Does shisha even qualify as "pure" shredded tobacco with all of its glycerin, honey, molasses, dyes, and flavorings? They're most likely testing with Tombak or however you spell it, although none of us can be sure. There is an enormous of lack of details in the article for any conclusions to be drawn. I don't even know what they're 'smoking' and testing on.

As many people before me have said, smoking in any way is obviously bad for you. Are cigarettes worse for you than shisha? In my opinion, I say they are, but not by much. I say that because most cigarettes have weird additives like ammonia and stuff that can't be good for you, but shisha delivers more nicotine (unwashed) and carbon monoxide. I don't know for sure, thats just the way I like to see it.

The hookah = pack of cigarettes reference in the article does not appear to refer to his own research, so his "pure, unshreaded" comment is meaningless.

There is "enormous lack of details" here because it is not a study, despite what the title of this thread (annoyingly) implies. This is a press release. Press releases don't have numbers and they don't have methodological details. You people are reading a news report on the epidemiology of hookah smoking that makes passing references to the danger of hookah smoking (a totally different issue!), and pretending like it's a study on the dangers of hookah smoking. Amazing. Edited February 6, 2007 by mgcsinc

[Gex]

Well obviously it smoking a hookah isn't going to be as healthy as drinking your five cups of tea a day...

From what I've seen, research into hookahs is still young and rather ignorant. They're trying to get the facts, which is fine, but the media's sure to use early results to freak everyone out. Well, I'd just assume they would by now.

I wouldn't think these Doctor's are the type to know the customs and customs and what's usual for the majority of the populace that takes part in the activity. If they decide to set their experiment methods off of somebody smoking apple chewing tobacco out of his pipe, and also happens to be a chain smoker, you can be guaranteed there's going to be some bogus data. But then again, they're doctors, I'd really hope they'd have done their research. (<--That was a heck of a clause, what, four verb words in therr? >.>)

Aside from press releases trying to tell us a hookah session is similar to smoking 200 cigarettes in one sitting, I like to think these guys are working with good intentions. Maybe somebody will be able to make a product with even less nicotine someday using their research, or some other nifty thing might come out of this. But still, I think it's too early to be saying these are the dead-set facts. And some of those statements do make me wonder...

If someone finds the actual research data, please post it, I'd love to have a look. Maybe I'm just a geek.

Edit: And before anybody says it, I know this isn't a study in and of itself. The data and what not I'm speaking of is in reference to the studies from which the information was taken for writing this article. I don't think I made it very clear when I was talking about which, so I thought I should mention that. Edited February 6, 2007 by Gex

[hookah~rob~]

normally dont post comments, just lurk, but frankly i understand that this is a news report. i would like to read the actual study to examin the way they ran the study and to find out more. i have thought about doing a study on my own but i do not have that kind of background. are there any studys that illustrate what would happen if there is a certain mix of water to alcohol ratio ( because tar is solubule in alcohol) that reduces or eliminates the effects of smoking, and if so what other effects does it have on the human body. i understand perfectly that smoking is bad. i watched my father die from smoking and drinking all the time. it wasnt pretty. what i have found is that a) those who smoke hookah tend to do so less frequently than a cigarette smoker there appear to be less additives in hookah tobaco c) hookah seems to be far less addictive but not necessarily proven as such. i want to see data, not broad general statements. would appreciate any links if possible.

[Gex]

what would happen if there is a certain mix of water to alcohol ratio ( because tar is solubule in alcohol)

Quick off-topic comment; anyone know what the effects of alcohol inhaled in this manner are? As in, any toxicity changes, etc.?

[SLF_1452_]

I want to see a study with good research. Something that says explicitly:
We had four machines sharing a one hose hookah, taking 3-4 normal drags before passing it to the next machine.

I would LOVE to see that!

hahaha, one robot takes like 7 hits and the other 3 robots go: "Hey jackass! stop bogarding the hookah!"

[mgcsinc]

Well obviously it smoking a hookah isn't going to be as healthy as drinking your five cups of tea a day...

From what I've seen, research into hookahs is still young and rather ignorant. They're trying to get the facts, which is fine, but the media's sure to use early results to freak everyone out. Well, I'd just assume they would by now.

I wouldn't think these Doctor's are the type to know the customs and customs and what's usual for the majority of the populace that takes part in the activity. If they decide to set their experiment methods off of somebody smoking apple chewing tobacco out of his pipe, and also happens to be a chain smoker, you can be guaranteed there's going to be some bogus data. But then again, they're doctors, I'd really hope they'd have done their research. (<--That was a heck of a clause, what, four verb words in therr? >.>)

Aside from press releases trying to tell us a hookah session is similar to smoking 200 cigarettes in one sitting, I like to think these guys are working with good intentions. Maybe somebody will be able to make a product with even less nicotine someday using their research, or some other nifty thing might come out of this. But still, I think it's too early to be saying these are the dead-set facts. And some of those statements do make me wonder...

If someone finds the actual research data, please post it, I'd love to have a look. Maybe I'm just a geek.

Edit: And before anybody says it, I know this isn't a study in and of itself. The data and what not I'm speaking of is in reference to the studies from which the information was taken for writing this article. I don't think I made it very clear when I was talking about which, so I thought I should mention that.

Thanks for the well-reasoned post.

A couple comments:

- A pack of cigarettes is 20 cigarettes, not 200

- Cigarette companies have already had the technology to remove nicotine and a numer of carcinogens from their product for many years, and have chosen not to make use of these technologies because they produce cigarettes that don't/won't sell well.

- There's nothing geeky about wanting to see actual data :-) I'm going to post some in a few minutes. Edited February 7, 2007 by mgcsinc